Uriinipeetus

Uriinipeetus, or urinary retention, is a condition in which the bladder cannot be fully emptied or urine cannot be initiated despite a strong urge to void. It can present acutely, developing suddenly and requiring urgent evaluation, or chronically, with gradual or incomplete emptying over time.

Causes include obstruction (most commonly benign prostatic hyperplasia in men, urethral stricture, or pelvic organ prolapse), neurogenic bladder disorders (such as diabetes-related nerve damage or spinal cord injury), and medications with anticholinergic or opioid effects. Infections, inflammation, or postoperative swelling can also contribute. Less commonly, systemic illnesses or neurologic diseases may play a role.

Symptoms vary but often include inability to urinate or a weak, interrupted stream, lower abdominal or suprapubic discomfort, a frequent or urgent need to void, and in acute cases a markedly distended bladder. Some individuals may experience overflow incontinence. Physical examination may reveal a palpable bladder in acute retention.

Diagnosis relies on history and examination, supported by imaging and tests. A bladder scan or ultrasound measures post-void residual volume. Urinalysis and urine culture help detect infection. Additional studies, such as ultrasound of the kidneys or urodynamic testing, may be used to identify underlying causes. Evaluation for contributing conditions (such as BPH in men) is common.

Treatment begins with immediate bladder decompression, typically by catheterization. After stabilization, management targets the underlying cause: relief of obstruction (e.g., medications like alpha-adrenergic blockers or surgical treatment for BPH), restoration of bladder function in neurogenic cases, and treatment of infections with appropriate antibiotics. Chronic retention may require intermittent or long-term catheterization.

Complications can include urinary tract infections, hydronephrosis, kidney injury, and bladder dysfunction. Prompt diagnosis and treatment improve outcomes, with prevention focused on managing risk factors and monitoring individuals at higher risk.